EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : GOVIND SINGH RAO Insurance No. : 1513754585

Date of Birth : 15/06/2000 UHID : RJ01.0004731175
Gender : Male UAN : NA
Mobile Number : 6376237217 ABHA Number : NA
Email ID : NA ABHA Address : NA
Registration Date : 29/05/2024 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Unmarried Name of Father / : ASHOK SINGH RAO

Husband
Type Of Disability : NA
Present Address : Ummedpura, gadholi, Permanent Address : Ummedpura, gadholi,
masalpur,Dist:Karauli,Rajasthan masalpur,Dist:Karauli,Rajastha
n

Dispensary / : Laxminagar, Jaipur, RJ (ESIS Disp.) Dispensary / : Laxminagar, Jaipur, RJ (ESIS

IMP for IP IMP for Family Disp.)

CURRENT EMPLOYER DETAILS

Employer's Code : 15000567650000999 Name of Employer : RUDRAANSH HOLDINGS LLP

No.

Sub Unit's Code : None Date of : 21/05/2024

No. Appointment

Address of : 3 HATHI BABU KA BAAG,KANTI Branch Office : BO - Jaipur,Jaipur

Employer NAGAR,JAIPUR,Dist:JaipurRajasthan302 (Neharu Place),
NA

FAMILY DETAILS

Name Relation Date UHID/ABHA Number ABHA UAN/ Is Residing State/District

with of Birth Address Aadhaar with IP
IP

Rajasthan /
Ashok singh Rao Dependant 01/01/1961 RJ01.0004731176/N NA Yes
father A
Karauli

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 Rajasthan /
Brijesh kanwar Dependant 01/01/1980 RJ01.0004731177/N NA Yes
mother A
Karauli

NOMINEE DETAILS

UHID/
Name of Nominee Relation with IP Date of Birth Address of Nominee Percentage(%)
ABHA Number

Ummedpura, gadholi,
Brijesh kanwar Dependant mother NA NA masalpur,RajasthanDist:Kar 100
auli

Affix Your Family Photograph Here. (Attested and Stamped by

Employer / ESIC Official)

Signature / LTI of Registered Employee / IP

Signature / Stamp of ESIC Officer / Employer

Note:
· This e-Pehchan card affixed with photograph of family & duly attested by the Employer/ESIC Staff shall be requested for
availing cash/medical benefit.
· e-Pehchan card is a proof of registration under ESI scheme. However eligibility for various benefits depends upon the
contribution conditions. For further information on eligibility to various Benefits, please visit- www.esic.in

Printed By (Employer/User Name) : RUDRAANSH HOLDINGS LLP

IP Number : 1513754585
Address : Ummedpura, gadholi, masalpur,Dist:Karauli,Rajasthan

Date : 12/07/2024 9:20:46PM

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